Ranganath L, Norris F, Morgan L, Wright J, Marks V
Epsom General Hospital, Surrey, UK.
Diabet Med. 1998 Feb;15(2):120-4. doi: 10.1002/(SICI)1096-9136(199802)15:2<120::AID-DIA529>3.0.CO;2-I.
The therapeutic effect of acarbose is generally attributed to inhibition of amylase and brush border glucosidases and consequent impaired digestion and absorption of carbohydrates. We have investigated the possibility that acarbose may also influence the rate of gastric emptying by comparing plasma glucose and gastrointestinal hormone responses to an oral sucrose load with and without acarbose in 11 healthy subjects. Gastric emptying was assessed indirectly by measuring circulating paracetamol concentrations following administration of paracetamol along with the sucrose load. Peak plasma glucose, insulin, and glucose-dependent insulinotropic polypeptide (GIP) responses were reduced when sucrose was given with acarbose. There was a significant reduction in post-sucrose paracetamol levels with acarbose suggestive of a significant delay in gastric emptying. The failure of acarbose to induce change in circulating paracetamol concentrations until after 60 min is indicative of a delay in gastric emptying rather than an osmotic malabsorption. The exaggerated and sustained release of glucagon-like peptide-1 (7-36)amide (GLP-1) seen when sucrose was given with acarbose may play a part in the inhibition of gastric emptying. This study indicates that a significant delay in gastric emptying may be an added mechanism contributing to the therapeutic effect of acarbose.
阿卡波糖的治疗作用通常归因于对淀粉酶和刷状缘糖苷酶的抑制，以及随之而来的碳水化合物消化和吸收受损。我们通过比较11名健康受试者在服用和未服用阿卡波糖时口服蔗糖负荷后的血糖和胃肠激素反应，研究了阿卡波糖是否也可能影响胃排空速率。通过在给予对乙酰氨基酚的同时给予蔗糖负荷后测量循环中的对乙酰氨基酚浓度，间接评估胃排空情况。当蔗糖与阿卡波糖一起服用时，血浆葡萄糖、胰岛素和葡萄糖依赖性促胰岛素多肽（GIP）的峰值反应降低。服用阿卡波糖后，蔗糖后对乙酰氨基酚水平显著降低，提示胃排空明显延迟。阿卡波糖直到60分钟后才引起循环中对乙酰氨基酚浓度的变化，这表明是胃排空延迟而非渗透性吸收不良。当蔗糖与阿卡波糖一起服用时，观察到胰高血糖素样肽-1（7-36）酰胺（GLP-1）过度且持续释放，这可能在抑制胃排空中起作用。这项研究表明，胃排空明显延迟可能是阿卡波糖治疗作用的另一个机制。
